ROYAL COMMISSION: High-quality food is vital to wellness in aged care
The Royal Commission into Aged Care Quality and Safety held a panel of aged care chefs and hospitality staff on day 2 of the Cairns hearings, discussing the importance of food in aged care, as well as the current state of the industry food quality and nutrition.
Celebrity chef, Maggie Beer also made an appearance at the Royal Commission hearings explaining her motivation behind the Maggie Beer Foundation and how vital flavour is to the wellbeing of elderly people in aged care homes.
The panel consisted of two chefs, Nicholas Hall and Timothy Deverall, who have experienced the worst and best of aged care facilities, and hospitality manager, Lindy Twyford, who works in a nursing home that values good food for their residents.
Mr Hall and Mr Deverall both had issue with the current training in commercial cookery courses, which doesn’t cover aged care food requirements and believe training is still minimal.
They also raised concerns about budget stipulations from aged care facilities that only spend $6 to $7 per person a day on residents for their food.
“You are having to cut corners, you are having to use frozen foods, you are having to use processed foods just to feed the residents. At the end of the meal, if the resident was still hungry and they wanted more food, there was no more food to give them,” says Mr Hall.
“You see residents wasting away because they’re not getting enough food. It’s just a joke.
“[Food] is everything. It’s what [residents] look forward to at the end of the day, it’s what they get up for in the morning. It’s what they look for, a lot of other things have been cut. All these things are going by the wayside to save money. So at the end of the day, the food, it’s the number one thing for them.”
Mr Deverall was in agreement with Mr Hall, saying the budget he has to work towards can vastly change the quality of the food.
He says if a resident was provided $14-$17 to spend on food, that is considered a good facility for food, whereas the lower end of the scale facilities only give under $7 per resident.
Mr Deverall says this equates to secondary cuts of meat and second quality vegetables, as well as smaller portions with low protein content.
The Commission asked the panel if they had seen any unsafe practices in aged care in regards to food, with Mr Deverall and Mr Hall sharing their experiences, including reuse of food from other residents, reheating texture modified food, cold bain-marie’s, and not storing food correctly.
Mr Deverall explained what he described an “upmarket” aged care facility that had the “dirtiest kitchen” he had even been in, including maggots in the rubbish and a cold room full of rotten vegetables and off meat, which was expected to be served that day.
Comments from Ms Twyford showcased the positives of good food and nutrition provided in a supportive facility.
This included good quality food, variety in meals, requests from residents, restaurant-like serves, special crockery for those wishing to have independence and regular interaction with dietitians.
“I see the impact and the importance good food has on a resident. The residents love little things. It’s huge for the resident. It might be little things for us but huge to them. What seems like little things to us are huge to them,” says Ms Twyford.
“Nutrition is vitally important to both physical and emotional wellbeing because malnourishment will lead to wounds or bedsores. To them, it’s a social site in the dining room… It gives them importance and independence.”
Ms Twyford doesn’t believe her facility would be able to provide good quality food on $7 per resident a day.
When discussing dietary requirements, Mr Hall described a facility he worked at that had 75 percent of residents on a cut-up diet, because the nursing home received more funding from the Government if residents were on the cut-up diet.
Additionally, Mr Hall believes a hot box, equipment that can keep food warm during service, should be mandatory for facilities, since a large number of residents can receive cold meals.
Mr Hall and Mr Deverall both admit job satisfaction is important as a chef and the current system has resulted in many people wanting to leave their job due to complaints, lack of funding and inability to provide quality food because of the current restraints.
Mr Deverall wants an outcome where there is specific course for aged care cooking, higher staffing ratios to provide better service to residents and improved communication and technology use by facilities.
While Mr Hall wants more dietitian involvement, better systems for dietary requirements, suppliers of food to be more effectively monitored and allowance for feedback from residents.
Ms Beer followed the panel and expressed similar sentiments, calling for better, more flavoursome meals to be provided to residents. She also expressed deep concern and shock at the evidence she heard from the panel before her.
She has seen great and terrible food in aged care, which encouraged her to start a foundation around improving food quality and service, particularly in aged care.
Ms Beer believes as you lose your sense of taste as you age, the food needs to make up for that with smell.
“Every meal, every bite of sustenance should be of goodness but flavour first. Flavour, goodness and pleasure; without those three things in equal measures, [residents] don’t have enough to look forward to to get up in the morning. That is just so vital that we provide that,” says Ms Beer.
In Ms Beer’s opinion, the new standards brought in by the Government in early July don’t cover good food quality and there should be a system in place for resident feedback.
“Adequate is not enough for people who don’t have choice… There’s nothing about emotional wellbeing, the quality of life they deserve. There has to be, there’s community and Government understanding of the difference that we need to make and can make and must make,” explains Ms Beer.
Ms Beer finished her evidence stating she wants to see an improvement in training, respect and funding in aged care nutrition and food quality, because she believes the current system is lacking in all three areas.
Hearings continue tomorrow, July 17, in Cairns, QLD.